ID

25587

Beschrijving

Muster 39 - Krebsfrüherkennung - Frauen (Freigabe 22.10.2014). Formulare für die vertragsärztliche Versorgung - Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php --- Template 39 - Early Detection of Cancer Women (Released 10-22-2014). Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

Link

www.kbv.de

Trefwoorden

Versies (4)
  1. 29/1/17 29/1/17 -
  2. 16/8/17 16/8/17 -
  3. 7/9/17 7/9/17 -
  4. 7/9/17 7/9/17 -
Houder van rechten

Kassenärztliche Bundesvereinigung

Geüploaded op

7 de septiembre de 2017

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

KBV Early Detection of Cancer Women Template 39b

Duits Engels

KBV Early Detection of Cancer Women Template 39b

2 Formulieren  
Header
Beschrijving

Header

Health Insurance name
Beschrijving

Health Insurance name

Datatype

text

Alias
UMLS CUI [1]
C0021682
Patient Name
Beschrijving

Patient Name

Datatype

text

Alias
UMLS CUI [1]
C1299487
Patient address
Beschrijving

Patient address

Datatype

text

Alias
UMLS CUI [1]
C0421449
Patient Birth Date
Beschrijving

Patient Birth Date

Datatype

date

Alias
UMLS CUI [1]
C0421451
Insurance Company ID
Beschrijving

Insurance Company ID

Datatype

integer

Alias
UMLS CUI [1]
C1547687
Insurance number
Beschrijving

Insurance number

Datatype

integer

Alias
UMLS CUI [1]
C1549712
Status
Beschrijving

Status

Datatype

integer

Alias
UMLS CUI [1]
C0449438
Facility ID
Beschrijving

Facility ID

Datatype

integer

Alias
UMLS CUI [1]
C1549700
Physician ID
Beschrijving

Physician ID

Datatype

integer

Alias
UMLS CUI [1]
C1548646
Date
Beschrijving

Date

Datatype

date

Alias
UMLS CUI [1]
C0011008
Past Medical History
Beschrijving

Past Medical History

Date of birth
Beschrijving

Date of birth

Datatype

integer

Maateenheden
  • JJJJ
Alias
UMLS CUI [1]
C0421451
JJJJ
Examination date
Beschrijving

Examination date

Datatype

date

Alias
UMLS CUI [1]
C2826643
former cancer screening
Beschrijving

former cancer screening

Datatype

boolean

Alias
UMLS CUI [1]
C0199230
date of last cancer screening
Beschrijving

date of last cancer screening

Datatype

date

Alias
UMLS CUI [1,1]
C0199230
UMLS CUI [1,2]
C2826643
cytologic finding
Beschrijving

cytologic finding

Datatype

integer

Alias
UMLS CUI [1]
C1265900
cytologic finding group
Beschrijving

cytologic finding group

Datatype

text

Alias
UMLS CUI [1]
C3702111
gynecologic operation, radio- or chemotherapy of genitals
Beschrijving

gynecologic operation, radio- or chemotherapy of genitals

Datatype

boolean

Alias
UMLS CUI [1,1]
C0038902
UMLS CUI [1,2]
C0392920
UMLS CUI [1,3]
C1522449
gynecologic therapy
Beschrijving

gynecologic therapy

Datatype

text

date of gynecologic therapy
Beschrijving

date of gynecologic therapy

Datatype

date

Alias
UMLS CUI [1]
C2584899
count of pregnancies
Beschrijving

count of pregnancies

Datatype

integer

Alias
UMLS CUI [1]
C0032967
UMLS CUI [2]
C0000786
Current Medical History
Beschrijving

Current Medical History

Last menstrual period
Beschrijving

Last menstrual period

Datatype

date

Alias
UMLS CUI [1]
C0369661
pregnancy
Beschrijving

pregnancy

Datatype

boolean

Alias
UMLS CUI [1]
C0032961
pathologic gynecologic bleedings
Beschrijving

pathologic gynecologic bleedings

Datatype

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C0205480
discharge
Beschrijving

discharge

Datatype

boolean

Alias
UMLS CUI [1]
C0012621
intrauterine device
Beschrijving

intrauterine device

Datatype

boolean

Alias
UMLS CUI [1]
C0021900
ovulation inhibitor
Beschrijving

ovulation inhibitor

Datatype

boolean

Alias
UMLS CUI [1]
C0029968
hormone therapy
Beschrijving

hormone therapy

Datatype

boolean

Alias
UMLS CUI [1]
C0279025
which hormone therapy
Beschrijving

which hormone therapy

Datatype

text

hormone therapy indication
Beschrijving

hormone therapy indication

Datatype

text

Alias
UMLS CUI [1,1]
C0279025
UMLS CUI [1,2]
C3146298
Finding
Beschrijving

Finding

vulva inspection
Beschrijving

vulva inspection

Datatype

boolean

Alias
UMLS CUI [1,1]
C2381411
UMLS CUI [1,2]
C0425834
portio and vagina
Beschrijving

portio and vagina

Datatype

boolean

Alias
UMLS CUI [1,1]
C0425844
UMLS CUI [1,2]
C1185877
physical examination of inner genital
Beschrijving

physical examination of inner genital

Datatype

boolean

Alias
UMLS CUI [1,1]
C0037088
UMLS CUI [1,2]
C0200048
inguinal lymph nodes conspicuous
Beschrijving

inguinal lymph nodes conspicuous

Datatype

boolean

Alias
UMLS CUI [1,1]
C0729596
UMLS CUI [1,2]
C0437527
other findings requiring treatment
Beschrijving

other findings requiring treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0582103
Skin
Beschrijving

Skin

Datatype

boolean

Alias
UMLS CUI [1]
C0007114
Mamma
Beschrijving

Mamma

Datatype

boolean

Alias
UMLS CUI [1,1]
C0006141
UMLS CUI [1,2]
C0437086
axillary lymph nodes
Beschrijving

axillary lymph nodes

Datatype

boolean

Alias
UMLS CUI [1,1]
C0729594
UMLS CUI [1,2]
C2826279
hematochezia
Beschrijving

hematochezia

Datatype

boolean

Alias
UMLS CUI [1]
C0018932
abnormalities in stool
Beschrijving

abnormalities in stool

Datatype

boolean

Alias
UMLS CUI [1,1]
C1704258
UMLS CUI [1,2]
C0011135
Rectum palpation finding conspicious
Beschrijving

Rectum palpation finding conspicious

Datatype

boolean

Alias
UMLS CUI [1,1]
C1384593
UMLS CUI [1,2]
C1290912
Rectum stool sample
Beschrijving

Rectum stool sample

Datatype

boolean

Alias
UMLS CUI [1]
C1550661
Stool test positive
Beschrijving

Stool test positive

Datatype

boolean

Alias
UMLS CUI [1]
C0202010
gynacologic finding
Beschrijving

gynacologic finding

Datatype

text

Alias
UMLS CUI [1]
C0017411
Blood Pressure
Beschrijving

Blood Pressure

Datatype

text

Maateenheden
  • ___/___
Alias
UMLS CUI [1]
C0005823
___/___
Blood Pressure remeasurement
Beschrijving

Blood Pressure remeasurement

Datatype

text

Maateenheden
  • ___/___
Alias
UMLS CUI [1]
C0005823
___/___
Cytologic finding
Beschrijving

Cytologic finding

cytologic specimen not applicable
Beschrijving

cytologic specimen not applicable

Datatype

boolean

Alias
UMLS CUI [1,1]
C0545978
UMLS CUI [1,2]
C4287930
endocervical cells
Beschrijving

endocervical cells

Datatype

integer

Alias
UMLS CUI [1,1]
C4038423
UMLS CUI [1,2]
C0370003
proliferation
Beschrijving

proliferation

Datatype

text

Alias
UMLS CUI [1]
C1514485
Lactobacillus
Beschrijving

Lactobacillus

Datatype

boolean

Alias
UMLS CUI [1]
C0022938
vaginal flora
Beschrijving

vaginal flora

Datatype

boolean

Alias
UMLS CUI [1]
C1982070
vaginal flora cocci
Beschrijving

vaginal flora cocci

Datatype

boolean

Alias
UMLS CUI [1]
C0314746
Trichomonaden
Beschrijving

Trichomonaden

Datatype

boolean

Alias
UMLS CUI [1]
C0040923
candida
Beschrijving

candida

Datatype

boolean

Alias
UMLS CUI [1]
C0006837
Gardnerella
Beschrijving

Gardnerella

Datatype

boolean

Alias
UMLS CUI [1]
C0017098
group
Beschrijving

group

Datatype

text

Alias
UMLS CUI [1]
C3702111
comments
Beschrijving

comments

Datatype

text

Alias
UMLS CUI [1]
C0947611
further treatment
Beschrijving

further treatment

Datatype

integer

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C1517331
cytologic control after therapy
Beschrijving

cytologic control after therapy

Datatype

text

Alias
UMLS CUI [1,1]
C1522577
UMLS CUI [1,2]
C0582103
Footer
Beschrijving

Footer

Signature date
Beschrijving

Signature date

Datatype

date

Alias
UMLS CUI [1]
C0807937
Terug naar het begin van de pagina

Similar models

KBV Early Detection of Cancer Women Template 39b

2 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Health Insurance name
Item
text
C0021682 (UMLS CUI [1])
Patient Name
Item
text
C1299487 (UMLS CUI [1])
Patient address
Item
text
C0421449 (UMLS CUI [1])
Patient Birth Date
Item
date
C0421451 (UMLS CUI [1])
Insurance Company ID
Item
integer
C1547687 (UMLS CUI [1])
Insurance number
Item
integer
C1549712 (UMLS CUI [1])
Status
Item
integer
C0449438 (UMLS CUI [1])
Facility ID
Item
integer
C1549700 (UMLS CUI [1])
Physician ID
Item
integer
C1548646 (UMLS CUI [1])
Date
Item
date
C0011008 (UMLS CUI [1])
Date of birth
Item
integer
C0421451 (UMLS CUI [1])
Examination date
Item
date
C2826643 (UMLS CUI [1])
former cancer screening
Item
boolean
C0199230 (UMLS CUI [1])
date of last cancer screening
Item
date
C0199230 (UMLS CUI [1,1])
C2826643 (UMLS CUI [1,2])
cytologic finding
Item
integer
C1265900 (UMLS CUI [1])
cytologic finding group
Item
text
C3702111 (UMLS CUI [1])
gynecologic operation, radio- or chemotherapy of genitals
Item
boolean
C0038902 (UMLS CUI [1,1])
C0392920 (UMLS CUI [1,2])
C1522449 (UMLS CUI [1,3])
gynecologic therapy
Item
text
date of gynecologic therapy
Item
date
C2584899 (UMLS CUI [1])
count of pregnancies
Item
integer
C0032967 (UMLS CUI [1])
C0000786 (UMLS CUI [2])
Last menstrual period
Item
date
C0369661 (UMLS CUI [1])
pregnancy
Item
boolean
C0032961 (UMLS CUI [1])
pathologic gynecologic bleedings
Item
boolean
C0019080 (UMLS CUI [1,1])
C0205480 (UMLS CUI [1,2])
discharge
Item
boolean
C0012621 (UMLS CUI [1])
intrauterine device
Item
boolean
C0021900 (UMLS CUI [1])
ovulation inhibitor
Item
boolean
C0029968 (UMLS CUI [1])
hormone therapy
Item
boolean
C0279025 (UMLS CUI [1])
which hormone therapy
Item
text
hormone therapy indication
Item
text
C0279025 (UMLS CUI [1,1])
C3146298 (UMLS CUI [1,2])
Item Group
vulva inspection
Item
boolean
C2381411 (UMLS CUI [1,1])
C0425834 (UMLS CUI [1,2])
portio and vagina
Item
boolean
C0425844 (UMLS CUI [1,1])
C1185877 (UMLS CUI [1,2])
physical examination of inner genital
Item
boolean
C0037088 (UMLS CUI [1,1])
C0200048 (UMLS CUI [1,2])
inguinal lymph nodes conspicuous
Item
boolean
C0729596 (UMLS CUI [1,1])
C0437527 (UMLS CUI [1,2])
other findings requiring treatment
Item
boolean
C0582103 (UMLS CUI [1])
Skin
Item
boolean
C0007114 (UMLS CUI [1])
Mamma
Item
boolean
C0006141 (UMLS CUI [1,1])
C0437086 (UMLS CUI [1,2])
axillary lymph nodes
Item
boolean
C0729594 (UMLS CUI [1,1])
C2826279 (UMLS CUI [1,2])
hematochezia
Item
boolean
C0018932 (UMLS CUI [1])
abnormalities in stool
Item
boolean
C1704258 (UMLS CUI [1,1])
C0011135 (UMLS CUI [1,2])
Rectum palpation finding conspicious
Item
boolean
C1384593 (UMLS CUI [1,1])
C1290912 (UMLS CUI [1,2])
Rectum stool sample
Item
boolean
C1550661 (UMLS CUI [1])
Stool test positive
Item
boolean
C0202010 (UMLS CUI [1])
gynacologic finding
Item
text
C0017411 (UMLS CUI [1])
Blood Pressure
Item
text
C0005823 (UMLS CUI [1])
Blood Pressure remeasurement
Item
text
C0005823 (UMLS CUI [1])
cytologic specimen not applicable
Item
boolean
C0545978 (UMLS CUI [1,1])
C4287930 (UMLS CUI [1,2])
Item
integer
C4038423 (UMLS CUI [1,1])
C0370003 (UMLS CUI [1,2])
endocervical cells
Code List
endocervical cells
CL Item
 (1)
CL Item
 (2)
proliferation
Item
text
C1514485 (UMLS CUI [1])
Lactobacillus
Item
boolean
C0022938 (UMLS CUI [1])
vaginal flora
Item
boolean
C1982070 (UMLS CUI [1])
vaginal flora cocci
Item
boolean
C0314746 (UMLS CUI [1])
Trichomonaden
Item
boolean
C0040923 (UMLS CUI [1])
candida
Item
boolean
C0006837 (UMLS CUI [1])
Gardnerella
Item
boolean
C0017098 (UMLS CUI [1])
group
Item
text
C3702111 (UMLS CUI [1])
comments
Item
text
C0947611 (UMLS CUI [1])
Item
integer
C0087111 (UMLS CUI [1,1])
C1517331 (UMLS CUI [1,2])
further treatment
Code List
further treatment
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
cytologic control after therapy
Item
text
C1522577 (UMLS CUI [1,1])
C0582103 (UMLS CUI [1,2])
Item Group
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial